How Supplement Companies Gain Influence Through Sponsoring Podcasts

Podwashing and Crooked Media

Brian Hagiwara/Getty Images

If you’ve listened to a podcast, there is a pretty decent chance you’ve heard an ad for a supplement or a probiotic, be it a regular advertisement injected between segments or something read by the host. (Some hosts even have their own line of supplements, but that’s another story altogether). It’s a smart advertising move. Podcasts are often well-researched, and the hosts are seen as either experts in their fields, experts at deep dives into topics, or both, hence their value. Via the close association with the podcast, the research skills and integrity of the hosts are transferred to the unstudied, unregulated product, which now seems more beneficial, wholesome, and backed by science, even when the data says otherwise. Many hosts are influencers, so they often have additional trust with their audience. I call this phenomenon of supplement advertising on podcasts podwashing, a riff on sportswashing. 

Sportswashing is the practice of organizations or governments gaining influence through the sponsorship of sports and athletes. We tend to see sports as fair and wholesome, and athletes are beloved, so oppressive governments and regimens can seem more benign by their association with sports. Sportswashing is the subject of the World Corrupt podcast, featuring Tommy Vietor (a cofounder of Crooked Media) and Roger Bennett (of Men in Blazers Media Network) as hosts. Season two tackles Saudi Arabia’s growing influence in the world of soccer. For those who don’t know, Crooked Media is a political media company founded by former Obama staffers (among their podcasts are the popular Pod Save America and Pod Save the World). They do a lot of great work getting factual information out to the public and also counteracting misinformation. If I wanted to podwash my supplement or probiotic, I’d definitely want to advertise with Crooked Media. 

It is not surprising, but sad all the same, that World Corrupt, a well-researched, educational, and entertaining podcast, is brought to you by Z-Biotics, a probiotic that claims to prevent the ill effects of drinking too much alcohol and whose advertising, in my opinion, promotes or at least minimizes binge drinking. In addition, the science behind the product doesn’t add up, and it hasn’t been studied in humans. Instead, before Z-Biotics launched publicly, they “gave out over 5,000 free samples” and “saw no consistent complaints attributable to the product.” (Giving out 5,000 free samples for feedback isn’t a scientific method; it’s marketing). Their batch testing involves the CEO/co-founder drinking “a bottle out of every batch himself, just to make sure nothing is off and no mistakes are made in manufacturing.”  

Neato. Super science-y.

A product with big claims and little data with the potential for promoting binge drinking, paying to sponsor a podcast about sportswashing hit me as very meta and not in a good way. Here’s a quote from the April 6, 2024, episode that ran right before an advertisement for Z-Biotics:

“That exact quandary, Rog, the money versus reputation question, is what we're going to talk about after this break.

My left eye is twitching. Badly. 

Z-Biotics doesn’t just have a company-produced ad injected into the podcast; no, we get the guys we have grown to trust reading the copy. Here's part of one:

Roger: Rough mornings after drinking, the inevitable sequel to night with drinks and the sequel, Tommy. Oh, it's never as good as the original, is it?

Tommy: No, except for The Godfather. Here's how it works. When you drink, alcohol gets converted into a toxic byproduct in your gut. It's this byproduct, not dehydration, that's to blame for your rough next day. Z-Biotics produces an enzyme to break this byproduct down. Just remember to make Z-Biotics your first drink of the night, drink responsibly, and you'll feel your best tomorrow.

What is Z-Biotics?

It is the probiotic B. subtilis ZB183™, which is genetically engineered to produce the enzyme acetaldehyde dehydrogenase. The company claims that if you drink it before you drink alcohol, it will accelerate the breakdown of acetaldehyde in the gastrointestinal tract, “setting you up for a better day after drinking.” Their central hypothesis is that it is the acetaldehyde produced in the gut accumulates and enters the body, causing a hangover. Sorry, the “particularly rough feelings you get the day after drinking.” 

However, the accepted science does not support acetaldehyde being responsible for a hangover/rough morning the next day. According to the Alcohol Hangover Research Research Group (Feb 2024), “previous studies often focused on the quick removal of acetaldehyde or incorrectly viewed the hangover as a consequence of dehydration. It is therefore not surprising that no proven effective and safe hangover treatments are currently marketed.” 

Let’s take a closer look, shall we? 

Alcohol Metabolism

When we drink, the alcohol enters our stomach and then intestines, where it is absorbed into a vein that takes blood directly to the liver. Here in the liver, the alcohol is metabolized, which means it is broken down into other substances for removal. The enzyme alcohol dehydrogenase first converts alcohol to acetaldehyde, a toxic (harmful) substance. However, acetaldehyde is quickly converted by another enzyme, acetaldehyde dehydrogenase, into acetate, which is further broken down into carbon dioxide and water. 

The liver chugs along, metabolizing alcohol as fast as it can, about one drink per hour, give or take, based on various factors. If the liver is presented with too much alcohol and it can’t keep up, the result is intoxication. Some alcohol remains in the gut, where it is also metabolized. The gut isn’t quite as good at converting acetaldehyde into acetate, so some acetaldehyde accumulates in the gut, and some is absorbed and heads to the liver.

What Causes a Hangover/Feeling Awful the Day After Drinking

A hangover is a constellation of awful symptoms, and according to the Alcohol Hangover Research Group, it is a “common consequence of excessive alcohol consumption.” A hangover only occurs when the blood alcohol has risen and come back down to zero, so it is the next morning phenomenon or an after-effect of drinking. The biology of hangovers is surprisingly complicated and not well understood. They appear to be multifactorial, which basically means many biological processes are likely involved, but we don’t know precisely because it’s complicated and/or understudied. That’s a far cry from Z-Biotics claim about acetaldehyde. Some factors that appear to be central to creating the hangover experience are:

• Inflammation from the alcohol or one of the breakdown products

• Oxidative stress (the presence of unstable molecules called free radicals, which can damage cells)

• The genetics of alcohol metabolism

• Congeners, which are compounds that develop due to fermentation and distilling (for example, the substance that makes rum dark or the small amounts of methanol in alcohol). 

Other factors that may be involved are sleep disruption and gastrointestinal tract irritation. 

Most of the studies, such as they are, suggest that the faster alcohol is metabolized, which means the quicker acetaldehyde is produced, the less severe the hangover. This points to alcohol triggering the biological cascade that leads to a hangover, not acetaldehyde. People with a genetic variation of acetaldehyde dehydrogenase that causes them to break down acetaldehyde more slowly can get flushing, nausea, headache, and feeling unwell from high levels of acetaldehyde, but this is not the same thing as feeling ill the next day. 

I am but a Gynecologist, So I Asked Some Liver Specialists

I first turned to Dr. Abby Philips, a hepatologist (liver specialist), who told me via email that “Acetaldehyde does not directly cause hangovers, and there is no strong evidence available for us to claim that reducing or quickly breaking down acetaldehyde reduces hangovers after alcohol use.” A hangover, he wrote, is “multifactorial.”

Because I am me, I asked another hepatologist. They are generally very smart and entertaining, so I enjoy listening to them. Next up on my list was Dr. Kaveh Hoda, who told me, "The awfulness of a hangover is multifactorial.” Dr. Hoda mentioned that alcohol also affects sleep and irritates the gastrointestinal tract, which may play a role.  

Dr. Philips also explained that acetate (one of the byproducts of alcohol metabolism) may even play a role in the "bad feeling and headache post-alcohol use.” This means that without studies, it’s possible that accelerating acetaldehyde metabolism could worsen a hangover. When something is unstudied, we don’t know what we don’t know. 

Dr. Philips and Dr. Hoda confirmed what I had read in numerous articles, in the Proceedings of the 12th Alcohol Hangover Research Group Meeting, and in the book Proof: The Science of Booze, written by Adam Rogers. If acetaldehyde plays a role in hangovers or “rough mornings,” the available evidence suggests it’s minor at best. There is also no robust evidence to suggest that acetaldehyde production in the gut plays a major role in hangovers. 

Acetaldehyde production in the gut may be responsible for some of the gastrointestinal side effects of drinking, like diarrhea. It may also be part of the risk of colon cancer associated with drinking, but this isn’t certain because alcohol is also directly toxic to the gastrointestinal tract. Might a probiotic that accelerates acetaldehyde metabolism in the gut reduce diarrhea after drinking or have other protective effects by reducing acetaldehyde in the bowel? It’s possible, but as of right now, that would be an untested hypothesis. 

Show Me The Research

Sometimes, we are unsure exactly how a product works, but quality, peer-reviewed studies show it does. Let’s look at the evidence; although it’s important to note that Z-Biotics isn’t a medication, while I might hold them to the same rigorous criteria for safety and efficacy as medications, our government does not.

The folks at Z-Biotics have published a peer-reviewed safety study showing their product wasn’t harmful to rats, which is an essential first step, although they seem to regret it. From their website:

We should all obviously just take the word of a for-profit company that their product couldn’t possibly have an unanticipated ill effect on mammals (that is written in heavy sarcasm font).

It is true that supplements don’t require ANY testing to go to market. However, probiotics are apparently considered a food ingredient, and a new one must pass a safety bar, albeit a low one, before it can go to market in the United States. 

On their website, Z-Biotics claims to have data showing that their product can reduce acetaldehyde levels in vitro (essentially in a test tube), but I can’t find a peer-reviewed study to support this claim. To ensure I wasn’t missing anything, I emailed the people at Z-Biotics, and I am correct; the only published paper is the rat study. They told me they were “finalizing a paper that shows the acetaldehyde breakdown kinetics in gut-simulated conditions in vitro” and would share the preprint with me confidentially. I don’t read these kind of papers confidentially. Proving that Z-Biotics can break down acetaldehyde in a simulated model is another important step, but to be clear, the ability of the product to break down acetaldehyde in a lab isn’t something I’m questioning. Call me old-fashioned, but I believe that you should have human data when you sell a product to humans. 

I asked about human trials, knowing that one of the co-founders, Zack Abbott, Ph.D. has experience in clinical trial design, and this was the reply answer: 

We would like to do this, and we hope to be able to eventually. Given the extremely difficult nature of designing a quality study taking into account different human physiologies and responses to alcohol and perceptions of pain and discomfort the next day, we struggled to be able to design a truly rigorous scientific in vivo study in humans that would meet our standards and also be eligible for IRB approval, given the relatively strict limits they set on BAC levels for human studies. For instance, it is very difficult to obtain approval for a study in which a person’s BAC goes above 0.08-0.1, which is essentially right at the threshold of intoxication, and really only the very beginning of where people might start to feel symptoms the next day. The signal-to-noise ratio at that level of intoxication is very low, and so it would be difficult to get a reliable response from people. Sampling colonic acetaldehyde would be very invasive and unpleasant (and expensive), and so as a small company we’ve opted to not do a sub-par or extremely invasive study just yet.

There is a lot to unpack here. 

My conclusion from this reply is that their target audience isn’t someone who has some stomach irritation from one drink; it’s someone who expects to be intoxicated, meaning heavy or binge drinking, which puts their advertising in a different light, especially the jokey sell on World Corrupt.

As for it being too challenging to get IRB approval for a human study involving alcohol intoxication, these studies do exist. That is how we know that several therapies are ineffective. However, admittedly, there are challenges with these kinds of studies. I asked Dr. Ryan Marino, a toxicologist, who told me that he “had an active study getting people intoxicated on alcohol as recently as 2019, and was looking at both metabolic products and cognitive effects, which is what they would need to do. It’s definitely possible, especially if there is an actual question, which this supplement’s claim seems to be.” In fact, while he said it was difficult, he was able “to get approval to get people to ethanol levels >0.20,” but it did require “demonstrating that we were a legitimate group using a legitimate lab, etc.” 

(Dr. Marino added that he didn’t think Z-Biotics would do anything medically for a hangover). 

Of course, there is a less expensive step BEFORE human studies–animal studies, specifically drunken rodents. Yes, there are animal models for studying the effects of alcohol and for sampling different body fluids and organs to test benefits or ill effects. In fact, I found a study from 2023 evaluating the impact of a genetically engineered probiotic on drunkenness and the ill effects of alcohol in mice. 

In this fascinating study, researchers genetically engineered a probiotic to express the enzyme ADH1B, which is a very effective variant of alcohol dehydrogenase (the first enzyme in the alcohol metabolism process). ADH1B apparently has the ability to convert alcohol into acetaldehyde about 100 times faster than regular ADH. The researchers introduced the gene for human ADH1B into Lactococcus lactis, a food-grade probiotic used in the dairy industry, and then tested the probiotic on mice. The mice treated with this probiotic were less likely to appear intoxicated, they recovered faster from alcohol exposure, and they had fewer resulting health problems than untreated mice. This study is also another strike against the Z-Biotics hypothesis because faster alcohol metabolism (meaning faster production of acetaldehyde) was beneficial. 

When interviewed about their findings by the American Society for Microbiology, one of the paper’s authors, Meng Dong, Ph.D., said the next steps were to investigate whether the potential benefits of the genetically modified probiotic extended to humans. One goal is to reduce “acute alcohol-induced liver and intestinal damage.”  

It’s absolutely possible to study the beneficial effects of a genetically engineered probiotic on alcohol-related complications in a rodent model. Then again, doing so risks proving your product is ineffective. 

Podwashing

In my opinion, it’s pretty despicable to have no data to prove your product has the intended clinical effect in mammals, never mind humans, and yet make bold claims about a grand mission to improve everyday living while also advertising that someone could drink three or ten drinks (yes, ten) and, if they take your product, not have to “spend a whole day recovering.”

At this point, I am compelled to point out that binge drinking is five or more drinks for men and four or more for women on the same occasion over 2-to 3 hours at least once in the past month, and heavy drinking is five or more drink/day or 15 drinks per week for men four or more on any day or eight or more drinks per week for women. Binge drinking and heavy drinking are associated with many health issues, including liver disease and liver failure, high blood pressure, stroke, heart disease, dementia, memory problems, and multiple cancers, including liver, breast, rectum, mouth, and esophagus. Even a single episode of binge drinking can have adverse effects on health. 

But even what we might think of as small amounts of alcohol carries risk, and according to the World Health Organization (WHO), there is no safe level of alcohol consumption. Of the two million new cases of breast cancer worldwide each year, about 100,000 are attributable to alcohol. And it doesn’t take much alcohol. In Europe, 25% of alcohol-related breast cancers are related to as little as one bottle of beer or 200 ml or 6.7 ounces of wine a day. Many people don’t like to hear this, but the evidence is what it is, and having this information is how you make informed decisions in your own life. 

Apart from the lack of evidence showing Z-Biotics has its intended effect, the risk here is that claims to reduce or prevent hangover symptoms or those “rough feelings” from drinking could encourage people to drink more than they usually would or lead someone to think the ill effects of binge drinking, heavy drinking, or even any drinking could be biohacked away. Even if Z-Biotics did work as it claims (and to be clear, there is no scientific evidence yet to suggest it can), the person taking it would still have the negative health consequences of drinking.  

According to Crunchbase, Z-Biotics raised $27.6 million in total venture funding and $22.4 million in its most recent round. Use some of that money to prove me wrong! How a company raises 27 million dollars based in part on a product with a medically questionable hypothesis that is untested in animal models and humans and is apparently too complicated/ethically challenging to study in humans yet fine to sell to humans for $12 a bottle ($7.17/bottle for a monthly 12-pack subscription) would make an interesting podcast episode. In fact, an entire Podcast dedicated to supplement and probiotic companies, their research, VC funding, the marketing of their products, and, of course, their podwashing would be really interesting. 

But I’m not sure Crooked Media is up to the task. It might affect their sponsorships. 

Hey, it’s a money versus reputation question.

References

Zakhari S. Overview: how is alcohol metabolized by the body? Alcohol Res Health. 2006;29(4):245-54. PMID: 17718403; PMCID: PMC6527027.

Tellez-Monnery K, Balikji J, Carrere L, Czerniczyniec A, Devenney LE, Guerra JI, Kiani P, Lores-Arnaiz S, Merlo A, Stock A-K, et al. Proceedings of the 12th Alcohol Hangover Research Group Meeting, in Buenos Aires, Argentina. Proceedings. 2024; 95(1):1. https://doi.org/10.3390/proceedings2024095001

Pittler MH, Verster JC, Ernst E. Interventions for preventing or treating alcohol hangover: systematic review of randomised controlled trials. BMJ. 2005 Dec 24;331(7531):1515-8. doi: 10.1136/bmj.331.7531.1515. PMID: 16373736; PMCID: PMC1322250.

Mackus M, van de Loo AJ, Garssen J, Kraneveld AD, Scholey A, Verster JC. The Association between Ethanol Elimination Rate and Hangover Severity. Int J Environ Res Public Health. 2020 Jun 17;17(12):4324. 

Joris C. Verster, The alcohol hangover–a puzzling phenomenon, Alcohol and Alcoholism. 2008;43:124–126, https://doi.org/10.1093/alcalc/agm163

Merlo A, Mackus M, van de Loo AJAE, van Neer RHP, Vermeulen SA, Thijssen SS, Knipping K, Bruce G, Garssen J, Verster JC. An evening of alcohol consumption negatively impacts next-day immune fitness in both hangover-sensitive drinkers and hangover-resistant drinkers. Addict Behav. 2023 Oct;145:107776.

Mackus M, van de Loo AJ, Garssen J, Kraneveld AD, Scholey A, Verster JC. The Association between Ethanol Elimination Rate and Hangover Severity. Int J Environ Res Public Health. 2020 Jun 17;17(12):4324. 

Salaspuro M. Microbial metabolism of ethanol and acetaldehyde and clinical consequences. Addict Biol. 1997 Jan;2(1):35-46. doi: 10.1080/13556219772840. PMID: 26735439.

Hangover, Chapter 8. Proof: The Science of Booze. Rogers, A. Houghton Mifflin Harcourt. May 27, 2014.

Naidu BA, Kannan K, Santhosh Kumar DP, Oliver JWK, Abbott ZD. Lyophilized B. subtilis ZB183 Spores: 90-Day Repeat Dose Oral (Gavage) Toxicity Study in Wistar Rats.  Journal of Toxicology, 2019, https://doi.org/10.1155/2019/3042108.

Karadayian AG, Mac Laughlin MA, Cutrera RA. Estrogen blocks the protective action of melatonin in a behavioral model of ethanol-induced hangover in mice. Physiol Behav. 2012 Sep 10;107(2):181-6. 

American Society Microbiology Press Release https://asm.org/press-releases/2023/april/a-protective-probiotic-blunts-the-ill-effects-of-a#:~:text=An%20enzyme%20called%20ADH1B%20accelerates,had%20fewer%20resulting%20health%20problems.

Jiang X,Yan C, Zhang H,Chen L,Jiang R,Zheng K, Jin W,Ma H,Liu X, Dong M,2023.Oral Probiotic Expressing Human Ethanol Dehydrogenase Attenuates Damage Caused by Acute Alcohol Consumption in Mice. Microbiol Spectr11:e04294-22.https://doi.org/10.1128/spectrum.04294-22

World Health Organization, Alcohol is One of the Biggest Risk Factors for Breast Cancer https://www.who.int/europe/news/item/20-10-2021-alcohol-is-one-of-the-biggest-risk-factors-for-breast-cancer#:~:text=There%20is%20no%20safe%20level,100%20ml%20each)%20every%20day.

Seitz HK, Becker P. Alcohol metabolism and cancer risk. Alcohol Res Health. 2007;30(1):38-41, 44-7. PMID: 17718399; PMCID: PMC3860434.

Bala, S., Marcos, M., Gattu, A., Catalano, D., & Szabo, G. (2014). Acute Binge Drinking Increases Serum Endotoxin and Bacterial DNA Levels in Healthy Individuals. PLOS ONE, 9(5), e96864. https://doi.org/10.1371/journal.pone.0096864